CEENTA otolaryngologist Dr. Roy Lewis appeared on WCNC's Charlotte Today on December 15, 2021 to discuss balloon dilation for the ears and sinuses.
Eugene Robinson: Do you have muffled hearing or popping or clicking of the ear? It could be caused by a cold, allergies, or a sinus infection. Here to tell us more about the symptoms and treatments is Dr. Roy Lewis with Charlotte Eye Ear Nose & Throat Associates. Doctor Lewis, how are you doing today, sir?
Dr. Roy Lewis: I'm doing well. How are you today?
Eugene: I'm doing wonderful. So, what are common ear and nose conditions that happen this time of the year, sir?
Dr. Lewis: So, this time of year, we see a lot of kids with acute otitis media, really bad ear pain, the younger patient population. And adults, we see more common cold, stuffy runny nose, lots of good drainage out of the nose, down the back of the throat and then sometimes that'll turn into a good sinus infection. Some of the adults will also get ear infections.
Eugene: Can over-the-counter medication help with that?
Dr. Lewis: You know, there actually are some really good over-the-counter options. I love saline spray, Simply Saline, NeilMed sinus rinse, saline flushes. It seems kinda counterintuitive to squirt stuff in your nose when you have all that drainage but it helps to get the mucus moving in the correct direction. Over the counter, they sell Mucinex DM. I like the branded product, 1200 milligrams twice a day. That can take four or five days, but initially, that's a good option. For our sinus patients, very early on, I like for them to use Afrin but not for more than three days. It has a really high rebound effect, but for three days, it can open you up and let you drain out.
Eugene: When those options don't work, when should someone see a doctor?
Dr. Lewis: So, most good viruses are going to run their course in five-to-seven days. And so, you've done these conservative measures in five-to-seven days. You're still having pretty significant symptoms. That's the time to head in. Then we may have a full sinus infection where you need an antibiotic.
Really significant facial pain, that's often times more going to be a sinus infection versus a run-of-the-mill cold but five-to-seven days of residing symptoms. That's time to head in.
Eugene: There's an interesting technique called balloon dilation. Could you go a little bit more into detail with that?
Dr. Lewis: Yeah, balloon dilation, it's pretty cool. It came out in actually 2006. It's a technique I've employed since 2008, and it's for our patients that have chronic sinusitis. So, it's not somebody that has the acute cold. It's not somebody that, you know, they get sick once or twice a year. It's so that throughout the year, all year long, they're getting sick and they've done conservative things. They've done saline sprays, topical nasal steroid sprays, and then what we do is we place a tiny little guide wire into the sinus, we place the balloon over the guide wire, inflate the balloon, deflate the balloon, and remove it. It can be done in the office under local anesthesia, and that's for the sinuses.
Since the technology came out, they now do it for the eustachian tube, and so for our adult patients that have chronic fluid in their ear and you know, chronic, they've had multiple sets of PE tubes. You can actually place a similar balloon in the eustachian tube which is in the back of the nose, inflate it for two minutes, deflate it and remove it all in the office.
Eugene: Who would be a great candidate for this balloon dilation?
Dr. Lewis: So, the sinus patient that they've been on multiple antibiotics and they've been doing this for several years and then, we do a CT scan on them and it shows that they have evidence of chronic sinusitis, they're a great patient. They want to avoid going to the operating room and are okay doing the procedure under local anesthesia.
From a balloon dilation of the eustachian tube perspective, I really think my my perfect patient is my 60 plus-year-old patient that's had five sets of PE tubes and they're tired of PE tubes and this is an option for them to get rid of their PE tubes so they can go swim again and heal the heal the hole where the PE tube used to be, and their topical medications like nasal steroids sprays aren't working.
Eugene: Charlotte Eye Ear Nose & Throat Associates has locations all around Charlotte, including the Mooresville office where you can find Dr. Lewis. To learn more, visit We Just Make Sense.com. Dr. Lewis, thank you very much.
Dr. Lewis: Thank you much.
Learn more about balloon sinuplasty and eustachian tube balloon dilation, and schedule your next ENT appointment with Dr. Roy Lewis at our Mooresville office today!